Test 4 Study Guide Flashcards
Surfactant replacement therapy is for
_____
Respiratory distress
____ is the most common cause of death of surfactant deficiency
Pediatric RDS
Surfactant reduces _____
Surface tension
Alveoli is formed at ____ weeks
32 weeks
_____ prevents alveolar collapse during exhalation
Surface tension
The stage when type II cells mature
22 weeks
Any baby over ____ weeks can be saved.
22 weeks
Steroid given 24-48 hours before delivery to speed up lung development
Dexamethasone
_____ is prevention treatment
Prophylactic
Two main strategies for the prevention of neonatal ARDS in cases of preterm delivery
- Antenatal administration of hormones
- Prophylactic treatment with surfactant soon after birth
Surfactant accelerates ______ pneumocytes
Type II pneumocytes
( increase exchange and improve lung mechanics. Maximal lung volume, compliance and gas exchange.)
Administration of surfactant is based on ____ and ____
gestational age and birth weight
Outcomes of surfactant
Increased compliance
Decreased WOB
Decreased shunting
Decreased atelectasis
Improvement of shunt ratio
Can’t survive without ___ protein
B protein
Rescue surfactant is only for ____
ARDS
Surfactant is given in the ____ position
Supine
Complications of surfactant
Plugging of the ETT
Bradycardia
The temperature for surfactant should be ____
Room temperature
You need _____ for surfactant delivery
Multiaccess
_____ stage continues after birth
Alveolar postnatal stage
Layer where lung tissue is formed
Endodermic layer
Stage that occurs during gestational weeks of 7-17
Pseudoglandular stage
Stage in which the alveolar sac develops
Canalicular stage
Stage develops between 17-26 weeks
Canalicular stage
Formulation of type I and type II pneumocytes
20-22 weeks gestation (Canalicular stage)
Stage between 27-36 weeks
Saccular stage
Alveoli appear at _____ weeks gestation
32 weeks
All conducting airways and respiratory branches are in place by ____ weeks
36 weeks
____ stage is 36 weeks gestation through after birth
Alveolar stage
_____ retains surfactant and aids in its distribution
Tubular myelin
Can cause difficulty breathing and decreased gas exchange
Overexpansion of the lungs
____ blocks inflammatory mediator production
Protein A and D
decreased number of airways, cells, alveoli. Can be caused by tumor or anything that takes up more space in the lungs. Very rare. Decreased size and weight of lungs.
Pulmonary hypoplasia
the most common condition associated with restricted growth due to lung compression.
Congenital diaphragmatic hernia (CDH)
_______ is important as it provides a barrier against infection
Amniotic fluid
abnormally high level of fluid
Polyhydramnios
inadequate level of fluid
Oligohydramnios
Most common cause of respiratory distress in neonates
Pediatric ARDS
Signs of pediatric ARDS
Retractions, grunting = NOT CYANOSIS
At 28 weeks, ____ hasn’t developed yet and should be given through the ETT
Surfactant
Normal pediatric RR
30-60
Normal pediatric SPO2
> 88%
Normal pediatric blood pressure
80/50
Normal pediatric HR
120-160
Baby Tory - 28 week c section, 140 HR, 49 RR, 35, 82%
What should we do?
Surfactant STAT through ETT then bubble CPAP for oxygenation
____ can check if baby has surfactant production before birth
Amniocentesis
Natural surfactant can come from ____
Cows and pigs
____ surfactant is made in a lab from protein B and C
Synthetic surfactant
When do we need HFNC v. CPAP?
HFNC is just for oxygenation. CPAP is for ventilation and oxygenation (baby BIPAP).
3 layers
Endoderm
Mesoderm
Ectoderm
Endoderm produces ___
the cecum, intestine, stomach, liver, digestive tract
Ectoderm produces ____
Sensory and skin
Mesoderm produces _____
heart and lung, connective tissues
Valve formation creates ______ blood flow.
unidirectional
____ creates circulation between mother and child and that’s where gas exchange occurs
Placenta
____ removes waste from the fetus’ blood and acts as a barrier to protection the fetus from infection
Placenta
____ provides oxygenated blood to the fetus
Umbilical vein
_____ removes deoxygenated blood from the fetus
Umbilical artery
______ connects umbilical vein and inferior vena cava.
Ductus venosus
oxygenated blood from placenta enters the fetus through the _____
Umbilical vein
Blood bypasses the liver via _____
ductus venosus
Blood bypasses the liver through the ductus venosus and enters the ______
inferior vena cava
- Oxygenated blood from placenta enters the fetus through umbilical vein.
- Blood bypasses liver via the ductus venosus
- From ductus venosus, enters inferior vena cava.
- From inferior vena cava, blood enters R atrium
- From R atrium goes to L atrium through Field and bypasses lungs.
